| NPI | 1154928281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 347C00000X Private Vehicle | |
| 3747P1801X Technician, Personal Care Attendant | |
| 374J00000X Doula | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |